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Review
. 2023 Mar;37(3):247-257.
doi: 10.1037/neu0000816. Epub 2022 Apr 28.

A cultural neuropsychological approach to harmonization of cognitive data across culturally and linguistically diverse older adult populations

Emily M Briceño  1 , Miguel Arce Rentería  2 , Alden L Gross  3 , Richard N Jones  4 , Christopher Gonzalez  5 , Rebeca Wong  6 , David R Weir  7 , Kenneth M Langa  8 , Jennifer J Manly  2
Affiliations
Review

A cultural neuropsychological approach to harmonization of cognitive data across culturally and linguistically diverse older adult populations

Emily M Briceño et al. Neuropsychology. 2023 Mar.

Abstract

Objective: To describe a cultural neuropsychological approach to prestatistical harmonization of cognitive data across the United States (U.S.) and Mexico with the Harmonized Cognitive Assessment Protocol (HCAP).

Method: We performed a comprehensive review of the administration, scoring, and coding procedures for each cognitive test item administered across the English and Spanish versions of the HCAP in the Health and Retirement Study (HRS) in the U.S. and the Ancillary Study on Cognitive Aging in Mexico (Mex-Cog). For items that were potentially equivalent across studies, we compared each cognitive test item for linguistic and cultural equivalence and classified items as confident or tentative linking items, based on the degree of confidence in their comparability across cohorts and language groups. We evaluated these classifications using differential item functioning techniques.

Results: We evaluated 132 test items among 21 cognitive instruments in the HCAP across the HRS and Mex-Cog. We identified 72 confident linking items, 46 tentative linking items, and 14 items that were not comparable across cohorts. Measurement invariance analysis revealed that 64% of the confident linking items and 83% of the tentative linking items showed statistical evidence of measurement differences across cohorts.

Conclusions: Prestatistical harmonization of cognitive data, performed by a multidisciplinary and multilingual team including cultural neuropsychologists, can identify differences in cognitive construct measurement across languages and cultures that may not be identified by statistical procedures alone. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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Figures

Figure 1.
Figure 1.
Linking items and confidence ratings across cohorts.
Figure 2.
Figure 2.
Comparison of DIF-adjusted and non-DIF-adjusted General Cognitive Performance factor scores in HRS-HCAP and Mex-Cog among the confident and tentative linking items. Figure Caption: Kernel density plots of standardized differences between non-DIF-adjusted factor scores and factor scores incorporating DIF. Y axis displays the probability density function describing the relative proportion of observations, stratified by cohort, along the x-axis. Panel A displays factor scores generated from confident linking items only. Panel B displays factor scores generated from both confident and tentative linking items, with confident linking items that showed negligible or no significant DIF treated as DIF-free anchor items.
See this image and copyright information in PMC

References

    1. Acevedo A, Loewenstein DA, Agrón J, & Duara R (2007). Influence of sociodemographic variables on neuropsychological test performance in Spanish-speaking older adults. Journal of Clinical and Experimental Neuropsychology, 29(5), 530–544. - PubMed
    1. Arango-Lasprilla J, Rivera D, Rodríguez G, Garza M, Galarza-Del-Angel J, Rodriguez W, Velazquez-Cardoso J, Aguayo A, Schebela S, & Weil C (2015). Symbol digit modalities test: normative data for the Latin American Spanish speaking adult population. NeuroRehabilitation, 37(4), 625–638. - PubMed
    1. Arce Renteria M, Manly JJ, Vonk JMJ, Mejia Arango S, Michaels Obregon A, Samper-Ternent R, Wong R, Barral S, & Tosto G (2021, Aug 11). Midlife Vascular Factors and Prevalence of Mild Cognitive Impairment in Late-Life in Mexico. J Int Neuropsychol Soc, 1–11. 10.1017/S1355617721000539 - DOI - PMC - PubMed
    1. Briceno EM, Gross AL, Giordani BJ, Manly JJ, Gottesman RF, Elkind MSV, Sidney S, Hingtgen S, Sacco RL, Wright CB, Fitzpatrick A, Fohner AE, Mosley TH, Yaffe K, & Levine DA (2021). Pre-Statistical Considerations for Harmonization of Cognitive Instruments: Harmonization of ARIC, CARDIA, CHS, FHS, MESA, and NOMAS. J Alzheimers Dis, 83(4), 1803–1813. 10.3233/JAD-210459 - DOI - PMC - PubMed
    1. Camilli G, Shepard LA, & Shepard L (1994). Methods for identifying biased test items (Vol. 4). Sage.